scholarly journals TREATMENT-RESISTANT BLOOD PRESSURE AMONG PATIENTS WITH CORONARY ARTERY DISEASE – CAUSE FOR CONCERN: NEW DATA FROM THE EXTENDED FOLLOW-UP OF THE INTERNATIONAL VERAPAMAIL SR-TRANDOLAPRIL STUDY (INVEST)

2012 ◽  
Vol 59 (13) ◽  
pp. E1498 ◽  
Author(s):  
Rhonda M. Cooper-DeHoff ◽  
Yan Gong ◽  
Eileen Handberg ◽  
Franz Messerli ◽  
George Bakris ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Treatment Resistant ◽  
Artery Disease

P5468Systolic versus diastolic blood pressure as predictors of cardiovascular events among treated hypertensive patients: a 6-year prospective study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kasiakogias ◽  
C Tsioufis ◽  
D Konstantinidis ◽  
P Iliakis ◽  
I Leontsinis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Events ◽  
Cardiovascular Morbidity ◽  
Hypertensive Patients ◽  
Artery Disease ◽  
Worse Prognosis

Abstract Background/Introduction There has been a long debate regarding the association of systolic versus diastolic blood pressure with cardiovascular outcome and data regarding hypertensive patients under treatment have been conflicting. Purpose To investigate the association of different patterns of uncontrolled blood pressure (BP) among treated hypertensive patients. Methods We prospectively studied 1507 treated hypertensive patients (age 59±11 years) that are followed in the setting of a single-center, clinic-based registry. During follow-up, patients underwent regular visits for hypertension and risk factor management. Based on the cut-off limits for uncontrolled hypertension of office systolic BP≥140mmHg and diastolic BP≥90mmHg, study participants were divided into four groups: those with controlled hypertension (796 patients, 53% of the population), uncontrolled systolic BP (257 patients, 17%), uncontrolled diastolic BP (135 patients, 9%) and uncontrolled systolic and diastolic BP (319 patients, 21%). The outcome studied was the composite of cardiovascular morbidity set as coronary artery disease and stroke, and the controlled hypertension group served as reference. Results The median follow-up period was 6.4±3.0 years and the composite endpoint (13 strokes and 41 cases of coronary artery disease) occurred in 54 patients (3.6%). Unadjusted Cox regression analysis showed that, compared to the reference group of controlled hypertensives, the risk for cardiovascular morbidity was similar in patients with uncontrolled diastolic BP (HR: 0.88, 95% CI: 0.26–2.97) but significantly higher in patients with uncontrolled systolic BP (HR: 2.17, 95% CI: 1.08–4.36), while patients with both uncontrolled systolic and diastolic BP showed the worse prognosis (HR: 2.35, 95% CI: 1.24–4.43). This pattern of risk was overall sustained after adjusting for different sets of confounders. Conclusions Among treated hypertensive patients, uncontrolled systolic BP is associated with a greater risk for cardiovascular events compared to uncontrolled diastolic BP while uncontrolled systolodiastolic hypertension presents with the worse prognosis.

Abstract P014: Poor Blood Pressure Control and Severe Coronary Artery Lesions Are Risks of Cerebral Microbleeds in Patients With Coronary Artery Disease During Antiplatelet Therapy

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Yoshiko Iwamoto
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Antiplatelet Therapy ◽  
Brain Hemorrhage ◽  
Coronary Artery Lesions ◽  
Severe Coronary Artery ◽  
Artery Disease

Background and Purpose: Brain hemorrhage is a serious complication of antiplatelet therapy, particularly dual antiplatelet therapy (DAPT), in patients with coronary artery disease (CAD) who undergo percutaneous coronary intervention (PCI). Cerebral microbleeds (CMBs) detected on MRI is a surrogate of symptomatic brain hemorrhage. However, little is known regarding CMBs in CAD patients during long-term antiplatelet therapy. Therefore, we investigated the temporal change of CMBs during antiplatelet therapy in CAD patients after PCI. Method: Brain MRI was performed at baseline and after 8-month follow-up in consecutive 14 patients who underwent PCI and antiplatelet therapy (DAPT in 13 patients). Results: Baseline MRI revealed CMBs in 2 patients (14%). New CMBs were detected by follow-up MRI in 2 other patients (14%). Although blood pressure (BP) at baseline did not differ between the CMB-positive and CMB-negative patients, BP after 8 months was significantly higher in CMB-positive patients than CMB-negative ones (systolic BP: p=0.03, diastolic BP: p=0.02). Moreover, CMB-positive patients had greater number of coronary artery lesions and higher SYNTAX score at baseline than CMB-negative patients (Figure). Conclusions: CAD patients with poor BP control and severe coronary artery lesions would be at higher risk for CMBs and eventually brain hemorrhage during antiplatelet therapy. Accordingly, strict coronary risk control, especially BP control, is necessary in CAD patients receiving long-term antiplatelet therapy.

scholarly journals In-Hospital Blood Pressure Variability: A Novel Prognostic Marker of Renal Function Decline and Cardiovascular Events in Patients with Coronary Artery Disease

2020 ◽  
Vol 45 (5) ◽  
pp. 748-757
Author(s):  
Kan Saito ◽  
Yuichi Saito ◽  
Hideki Kitahara ◽  
Takashi Nakayama ◽  
Yoshihide Fujimoto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Renal Function ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Renal Function Decline ◽  
Coefficient Variation ◽  
End Point ◽  
Artery Disease

Introduction: Several measures of blood pressure (BP) variability have been associated with kidney disease and cardiovascular events. Although BP is routinely measured during hospitalization in daily practice, the prognostic impact of in-hospital BP and its variability are uncertain. Methods: A total of 226 participants who underwent elective percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) were included. BP was measured by trained nurses during the 4-day hospitalization for PCI. BP variability was assessed by standard deviation (SD) and coefficient variation of systolic BP. Estimated glomerular filtration rate (eGFR) was calculated at baseline and follow-up (≥6 months). The cardiovascular end point was defined as a composite of cardiovascular death, acute coronary syndrome, stroke, heart failure hospitalization, and any coronary revascularization. Results: In-hospital BP was measured 9.5 ± 0.8 times. During a median follow-up period of 1.7 years, mean eGFR change was −1.7 mL/min/1.73 m2 per year, and 35 (15.5%) participants met the cardiovascular end point. Mean systolic BP and SD were negatively correlated with eGFR change. In the receiver operating characteristic curve analysis, SD of systolic BP predicted the cardiovascular end point (AUC 0.63, best cutoff value 14.2 mm Hg, p = 0.003). Kaplan-Meier analysis demonstrated a significantly higher incidence of the cardiovascular end point in patients with SD of systolic BP ≥14.2 mm Hg compared to their counterpart (p = 0.003). A multivariable analysis showed SD of systolic BP as an independent predictor for the cardiovascular end point. When assessed with coefficient variation, BP variability was similarly related to eGFR change and clinical outcomes. Conclusion: Greater in-hospital BP variability was associated with renal function decline and cardiovascular events in patients with stable CAD.

Serum FGF-21 Is Associated with Future Cardiovascular Events in Patients with Coronary Artery Disease—Results from a Median Follow-Up of 4.8 Years Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 426-P
Author(s):  
YUQIAN BAO ◽  
YUN SHEN ◽  
XUELI ZHANG ◽  
YITING XU ◽  
QIN XIONG ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Artery Disease

Long-Term Follow-Up of Patients With Isolated Side Branch Coronary Artery Disease

Angiology ◽  
2021 ◽  
pp. 000331972110280
Author(s):  
Sukru Arslan ◽  
Ahmet Yildiz ◽  
Okay Abaci ◽  
Urfan Jafarov ◽  
Servet Batit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vessel Diameter ◽  
Side Branch ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Artery Disease

The data with respect to stable coronary artery disease (SCAD) are mainly confined to main vessel disease. However, there is a lack of information and long-term outcomes regarding isolated side branch disease. This study aimed to evaluate long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients with isolated side branch coronary artery disease (CAD). A total of 437 patients with isolated side branch SCAD were included. After a median follow-up of 38 months, the overall MACCE and all-cause mortality rates were 14.6% and 5.9%, respectively. Among angiographic features, 68.2% of patients had diagonal artery and 82.2% had ostial lesions. In 28.8% of patients, the vessel diameter was ≥2.75 mm. According to the American College of Cardiology lesion classification, 84.2% of patients had either class B or C lesions. Age, ostial lesions, glycated hemoglobin A1c, and neutrophil levels were independent predictors of MACCE. On the other hand, side branch location, vessel diameter, and lesion complexity did not affect outcomes. Clinical risk factors seem to have a greater impact on MACCE rather than lesion morphology. Therefore, the treatment of clinical risk factors is of paramount importance in these patients.

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